In children, congenital or acquired factors can cause the neurogenic bladder. Lifelong clean intermittent catheterization (CIC) is often required in children with neurogenic bladder. Urinary catheterization is known to be a risk factor for bacteriuria and recurrent urinary tract infections. In this study, it is aimed to investigate the factors that affect urinary tract infections in children with CIC due to neurogenic bladder.

Material and methods:

CIC-dependent forty six pediatric patients with neurogenic bladder who were followed at Çukurova University, Department of Pediatric Nephrology outpatient clinic from January 2017 to March 2018 were analysed retrospectively.

Results:

The mean age of the patients is 10 years and 6 months (1-18 year). 45 % of the patients were female. Average age of starting to use CIC is 5 years and 10 months for all patients.Vertebral anomaly was detected in 40.9% of all patients. The rate of VUR was 40% in patients, whereas in DMSA the scar was found to be 46%. The rate of patients who had no urinary tract infection in the last 1 year was 52.1%.For all of the patients who have used CIC in the last 1 year, the average number of urinary tract infection is 1.2. While the average number of urinary tract infection for the patients who have VUR was 2, the average number of UTI for the patients who do not have VUR in the last year was 0.8. The most common microorganism isolated in urinary cultures was ESBL-positive Escherichia coli (40%) while the others were ESBL (+) Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis, ESBL (-) E. coli.

Conclusions:

ESBL (+) E. coli is the most common factor that causes UTI in children with CIC with neurogenic bladder. The presence of VUR accompanied by neurogenic bladder significantly increases the frequency of UTI.